ATTACHMENT - I V - Past Performance Questionnaire.docx
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- Solicitation number
- 12405B21R0025
About this file
This document contains a past performance questionnaire template and a solicitation for sealing windows and replacing damaged interior materials at a USDA research facility in Mississippi.
The past performance questionnaire is to be completed by commercial or government references for an offeror on a prior contract. It requests information on the contract, performance period, value, description of work, any problems encountered, and ratings for quality of services, personnel, subcontractor management, business relations, timeliness, customer satisfaction, and financial controls. A separate document provides guidelines for assigning performance ratings.
The solicitation seeks proposals to seal windows and replace water-damaged gypsum board and plastic laminate at the National Biological Control Laboratory building in Stoneville, Mississippi. Offerors must be registered in the System for Award Management and can attend an optional site visit. Proposals are due by a specified date. The work includes removing and replacing aluminum storefront windows and frames, water-damaged interior materials, and plastic laminate window stools with solid surface units.
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OFFEROR: SUBMIT TO YOUR COMMERCIAL CLIENT OR GOVERNMENT AGENCY REFERENCES FOR PAST PERFORMANCE
PAST PERFORMANCE QUESTIONNAIRE
TO BE COMPLETED BY COMMERCIAL CLIENT'S TECHNICAL MANAGER or BUSINESS MANAGER or AGENCY'S CONTRACTING OFFICER REPRESENTATIVE (COR) or CONTRACTING OFFICER (CO) Please forward completed Past Performance Questionnaire to Huron Virden, Contracting Officer, at huron.virden@usda.gov. Please ensure delivery no later 1:00 p.m. Central on July 29, 2021.
| 1. Contractor Name: |
| 2. Contract Number: |
| 3. Contractor Address: |
| 4. Contract Type: |
____ Fixed-Price ____ Cost-Reimbursement ____ Other (Please Specify) ____________________
5. Client / Agency Name:
Address:
6. Client / Agency Point of Contact:
Name:
Title:
Phone:
E-mail Address:
| 7. Period of Performance: |
| 8. Total Contract Value: $ |
9. Title of Project:
10. Please describe the work that was accomplished focusing on the scope and complexity of the work.:
11. Please describe whether the work was defined by the owner via a specification, statement of work, statement of objectives, partial/complete design document.
12. Did the Contractor encounter any noteworthy problems performing work? ________ If so, Please explain:
NOTE: Please use adjectival ratings from attached sheet
| 13. Evaluation Factor |
| 14. Comments (Attach additional sheets, if necessary.) |
| 15. Rating |
a. Quality of Services Received
b. Personnel
c. Subcontractor Mgmt
d. Business Relations
e. Timeliness of Performance
f. Customer Satisfaction
g. Financial Controls
16. Would you select this firm in the future for the same or similar services? Please explain.
| 17a. Name of Preparer: |
| 17b. Signature: |
| 17c. Title: |
| 17d. Date: |
PAST PERFORMANCE RATING GUIDELINES
Summarize contractor performance in each of the rating areas. Assign each area a rating of Unsatisfactory, Marginal, Satisfactory, Very Good, or Excellent. Use the following instructions as guidance in making these evaluations. Note: There is no corresponding guidance for “Customer Satisfaction”. Please use the comments area on the preceding form to justify the rating given “Customer Satisfaction.”
| Ratings |
| Quality of Services Received / Personnel |
-Compliance w/contract requirements -Effectiveness of design -Quality of construction -Accuracy of reports -Appropriateness of personnel assignments -Technical excellence
Financial Controls
-Within budget -Current, accurate, complete billings -Relationship of negotiated prices to actual -Efficiencies -Change orders issued Timeliness of Performance
-Met interim milestones -Reliable -Responsive to technical direction -Completed on time Business Relations / Subcontractor Management
-Effective on-site management and personnel -Businesslike correspondence -Responsive to contract requirements -Prompt notification of problems -Reasonable / cooperative -Flexible -Proactive -Effective Small Business Subcontracting Program
| Excellent |
| There were no quality problems |
| There were no Financial issues |
| There were no delays |
| Business relations and interaction were highly effective |
Very Good
Any nonconformance experienced did not impact achievement of contract requirements Financial issues did not impact achievement of contract requirements Delays did not impact achievement of contract requirements
Business relations and interaction were usually effective
Satisfactory
Nonconformance required moderate agency involvement to ensure achievement of contract requirements
| Financial issues required moderate agency involvement to ensure achievement of contract requirements |
| Delays required moderate agency involvement to ensure achievement of contract requirements |
Business relations and interaction were somewhat effective
Marginal
Nonconformance required major agency involvement to ensure achievement of contract requirements
| Financial issues required major agency involvement to ensure achievement of contract requirements |
| Delays required major agency involvement to ensure achievement of contract requirements |
Business relations and interaction were marginally effective
| Unsatisfactory |
| Nonconformance |
compromised the achievement of contract requirements Financial issues compromised performance
| Delays compromised achievement of contract requirements |
| Business relations and interaction were not effective and compromised achievement of contract requirements |
G14PS000
Attachment H Past Performance Questionnaire
12405B20R0016 Past Performance Questionnaire
File details come from the government source that posted it. Updated .